In Japan, incidence and mortality of cervical cancer is increasing especially in young women in their late 20s and early 30s. One of the considerable factors is the low coverage of screening which is only 32.7% according to the National Livelihood Survey 2013. We tried to use self-sampling HPV test to approach non-attendees in Izumo city, which has implemented HPV co-testing for cervical cancer screening since 2007. 2,120 out of 12,546 women who were between 25-45 years old and did not attend municipal cervical cancer screening from 2010 to 2014 conducted HPV self-sampling test in 2015. At our presentation in EUROGIN 2016, the acceptability of self-sampling HPV test was very good. We want to make sure if HPV test using a self-sampling device is really useful and effective for non-attendees. So we investigate how many women who conducted self-sampling HPV test went to the medical facility and received the cytology, especially as a municipal cervical cancer screening after they got the result of HPV test.
The candidates of this study were 2,120 women living in Izumo city, who conducted HPV self-sampling test in 2015. We followed up on their results of cytology and HPV test using physician collected samples. We sent a letter and a questionnaire to those who were HPV positive and did not receive municipal screening to find out if they receive screening in any other setting or not.
In 2,120 attendees of self-sampling HPV test, 152(7.2%) of women were screen-positive and 1,968(92.8%) women were screen-negative. 123(89.2%) of screen-positive women received cervical cancer screening. 111 out of 123 receive municipal screening (cytology and physician-collect HPV test) in Izumo city, and 40 of them had a detailed examination. The detection rate of CIN2+ in those who conducted self-sampling HPV test is 10.8%, and 18 times as many as the rate of CIN2+ in general screening run by Japan Cancer Society, which covers one third of population based cervical cancer screening in Japan. 239(12.1%) of screen-negative women receive municipal screening. 362 women (17.1% of the total 2,120) who conducted self-sampling HPT test went to the medical facility to undergo cytology as municipal screening. It is also 2.9% of total non-attendees in 5 years.
We believe that using self-sampling HPV test is a very useful and effective way to approach non-attendees of municipal cervical cancer screening. In Japan, there are many areas including small islands with few or no available facilities. Not only for non-attendees but also for women in low resource area in Japan, self-sampling HPV test has a possibility to improve the health and wellness of Japanese women.